Ahn, associate director in the Division of Global Health and Human Rights in the Department of Emergency Medicine at Massachusetts General Hospital in Boston, will present an Innovation Forum session on "Human Trafficking and the Health Care Provider" at CHA's annual gathering June 2-4. He will be joined by Sr. Catherine O'Connor, CSB, vice president for mission and sponsorship at Covenant Health Systems in Tewksbury, Mass.

"A lot of human trafficking goes undetected in the health care setting," said Ahn. "There are a lot of missed opportunities" to intervene and alert authorities.

He described human trafficking — which can include sex trafficking, forced labor, debt bondage or unlawful recruitment — as an "emerging public health problem" in the United States. Emergency departments, Ahn said, are "a big safety net for every community's most vulnerable populations," including those who are victims of trafficking.

Ahn believes clinicians — and especially those in emergency medicine — are on the front lines of identifying and assisting victims of human trafficking.

They can help, he said, "in terms of identifying people who are in trafficking situations; treating victims who need medical care, both physical and mental; referring them to other legal and social services; and preventing human trafficking."

Ahn and Sr. O'Connor will provide tips on how to identify and assist victims of trafficking. The U.S. Department of State offers a list of potential red flags:

The person lives with his or her employer or with multiple people in a cramped area.

The employer holds the worker's identity documents.

The individual is prevented from speaking with health care providers alone.

Answers seem rehearsed or scripted, and the person seems submissive or fearful.

There are signs of physical abuse.

When a health provider suspects a patient may be a victim of human trafficking, the State Department suggests asking more questions including:

Can you leave your job if you want to?

Have you or your family been threatened?

Are you in debt to your employer?

The State Department urges people to inform authorities when there is reason to believe an individual is being held through coercion or force. The department recommends calling local law enforcement, the National Human Trafficking Resource Center at (888) 373-7888 or the U.S. Department of Justice's National Worker Exploitation Complaint Line at (888) 428-7581.

Sr. O'Connor has been involved in the fight against trafficking both through her religious order, the Congregation of St. Brigid, and through her employer, Covenant Health Systems.

The congregation is a member of UNANIMA International, a nongovernmental organization made up of 17 religious congregations with 17,500 members in 72 countries. It works on trafficking and other issues, primarily through the United Nations.

Although the congregations work to assist trafficking victims globally, and to educate and influence policy makers, their U.S. members were "shocked to find out it's in our own neighborhoods," Sr. O'Connor said.

It's important to continue to raise public awareness about the buying and selling of people in the U.S. and elsewhere, she said, because victims can blend in, in open sight. "Amtrak is doing training now to help employees recognize passengers who may be trafficked," Sr. O'Connor said. "There is a dawning consciousness about human trafficking."

The International Labour Organization recently estimated that nearly 21 million people — or 3 out of every 1,000 people in the world — are victims of forced labor, "trapped in jobs which they were coerced or deceived into and which they cannot leave." More than a quarter of them are under the age of 18, the organization says.

The bulk of the victims are in the Asia-Pacific region, where 11.7 million people are victims of forced labor.

The U.N. defines human trafficking as "the recruitment, transportation, transfer, harboring or receipt of persons, by means of the threat or use of force or other forms of coercion ... for the purpose of exploitation." The international agency puts the number of people who are trafficked both within and outside their countries at 4 million annually, and says that 80 percent of them are female and half are children.

St. Mary's Regional Medical Center in Lewiston, Maine — a member of Covenant Health Systems — has cosponsored two conferences on human trafficking. The 2012 conference, titled "Not Here: A Call to Action Against Human Trafficking," included specialty tracks for health care professionals, law enforcement, social service agencies, faith-based organizations and community members.

"I find it difficult to even read some of the materials" about human trafficking, Sr. O'Connor admitted. But she said her faith obliges her to do everything she can to "care for the poor and vulnerable," a category that definitely includes victims of the slave trade.

There are signs of progress. Massachusetts Gov. Deval Patrick signed an anti-trafficking law in 2011 that includes mandatory minimum terms of five years and penalties that could reach life in prison and fines of up to $1 million for those who traffic others for sex or forced labor.

Efforts to pass similar laws are ongoing in other states, Sr. O'Connor said.

"We have a moral obligation to look at an issue that is so hideous," Ahn said. "As human beings we feel morally obligated to do something about this" in order to "identify people who are in trouble and have tools at the ready to assist them."